Is Cannabis Better than Alcohol for People Over 50?

Thanks to a wave of legalization and the resultant ease of access, marijuana use has been steadily rising over the past several years across most of the United States. Although young adults still make up the largest percentage of total users, recent data published by the Public Health Institute found that adults over 50 are the fastest-growing demographic of marijuana users.

Unfortunately, increased rates of use by Gen X and baby boomers could come with an increase in associated health risks. Here we share what we learned from recent research and experts in the field.

According to the 2024 University of Michigan National Poll on Healthy Aging, people over 50 commonly use marijuana to help them sleep better, to relieve pain and to manage anxiety or other mental health issues. That mirrors what Susan Bauer, D.O., a physician from Park Rapids, Minnesota, told us.

"The No. 1 thing for people over 50 seeing me for cannabis would be chronic pain," Bauer says. That is only one condition on a list of dozens that the state of Minnesota has authorized medical providers to issue medical marijuana cards for, though. Alzheimer's and other forms of dementia, glaucoma, virtually all cancers, PTSD, restless leg syndrome, sleep apnea, IBS and many others are also on the list.

In a growing trend across age groups, people are also replacing alcohol use with recreational cannabis use. When we asked Bauer about this, she urged caution. "Any transfer of addiction is never a good thing," she says. "That said, alcohol is more addictive than marijuana, which is about on par with caffeine."

We wondered whether marijuana — medical or recreational — actually helps with chronic pain, insomnia, anxiety, PTSD or other conditions. According to Brian Hutton, a senior scientist at the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada, evidence of these beneficial effects is mixed to somewhat lacking.

In a large literature review published in Plos One, Hutton and colleagues looked at 134 different studies on recreational and medical marijuana use. In an email interview, Hutton writes, "While individuals may use cannabis to manage chronic pain and other conditions, the evidence for its therapeutic benefits in older adults was inconsistent. Some studies suggested potential benefits for certain conditions like end-stage cancer, pain and Parkinson's disease, while other studies reported no benefit."

To get an everyday perspective, we talked to Michelle Haskell, a 53 year-old receptionist from Victoria, Minneota, who has been using cannabis since 2019. "I am strictly on edibles," she says. "I tried vaping and smoking it, but that's not for me."

Haskell received a medical use card in 2020 to support her mental health treatment, along with therapy, but she currently uses recreational products, which have been legal in Minnesota since 2023.

Haskell said she uses cannabis around four or five times a week, and that her alcohol consumption has gone down as a result. "I take two milligrams to calm my nerves, and sometimes up to 10 or 15 milligrams to help me sleep or if I want to experience a high."

While many of the benefits of cannabis seem largely anecdotal, the risks are not. "The biggest thing people choose to ignore is that marijuana is strongly linked to episodes of acute psychosis, like delusions and hallucinations, more so than any other drug," Bauer says. "Medically, cannabis is far, far safer than alcohol or opioids. No one dies directly from the toxicity, but we see a lot of accidents and hospitalizations from taking too much in an area once it's first been legalized."

While few people may use enough cannabis to trigger psychotic episodes, the health risks, especially for people over 50, can go far beyond that. "Our review found that cannabis use among older adults may be linked to several negative health outcomes," Hutton writes. "Overall, reports of harm outnumbered reports of benefits."

Among those risks are: increased falls and injuries due to cannabis-induced dizziness or sedation; cognitive impairment, including issues with memory, attention and decision-making; increased risk of negative drug interactions with prescription medication or other recreational drugs; and worsening mental health conditions, including depression, anxiety and potential cannabis use disorder.

When asked about potential health risks, Haskell says, "My provider's opinion is that we're in the infancy of this, we don't know the long-term effects, so don't use it as a crutch. What we've seen in the last five years is a lot news about the benefits of it, and maybe it's better than alcohol. But now they're saying that if you use it chronically it might have negative impacts on your brain or memory, so I'm mindful of that."

Haskell's mindful, lower-dose approach to using cannabis is one factor that may help her mitigate health risks. A 2022 paper with guidelines for safer use of cannabis published in the International Journal of Drug Policy urges people to avoid using high-potency THC products as well as to avoid smoking or vaping cannabis.

Bauer agrees that different delivery methods pose different risks. "Edibles and drinks are the safest for lung health, and they are absolutely more accurate in terms of knowing the amount of THC you're getting."

She cautioned, though, that food edibles like gummies can take longer to get into the blood stream, prompting some to ingest more because they haven't felt the effects from an initial dosage. This can result in acute anxiety, nausea or even psychotic episodes.

"There's always a pro and a con to any chemical or medication we put in our body, and marijuana is no different," Bauer says. The best advice in helping you navigate the pros and cons of cannabis? Have a frank discussion about it with your doctor.

Rashelle Brown is a long-time fitness professional and freelance writer with hundreds of bylines in print and online. She is a regular contributor for NextAvenue and the Active Network, and is the author of Reboot Your Body: Unlocking the Genetic Secrets to Permanent Weight Loss (Turner Publishing). Connect with her on Twitter and Instagram @RashelleBrownMN. Read More